This opinion piece summarises my observations of the internal functioning of multilateral organisations, made throughout decades of my professional experience and supported by recent research – in the rare instances where such research is available. This contribution is written to highlight the deficiencies that I consider critical for the survival of international organisations, and as an urgent call for change. To frame the arguments, elements of the responsible leadership concept are used: ethical and people-centred leadership, a true focus on effectiveness and long-term impact, meaningful engagement of civil society and genuine cooperation within and between international organisations. Issues related to internal justice systems, accountability for public resources, democracy and relevance of existing internal decision-making structures and effectiveness of internal communication systems – each tremendously important in its own right – are not covered for reasons of space. Each section describes what I see as key problems and their underlying reasons, and concludes with a set of proposals for how international organisations could fix these problems internally. In the last section, I reflect on the early days of the COVID-19 pandemic and how responsible leadership failures and operational deficiencies that were a longknown yet often unspoken reality became amplified during the crisis.